光动力疗法在肝外胆管癌的临床应用和研究进展

肝外胆管癌（eCCA）是一种起源于肝外胆管上皮细胞的高度侵袭性的恶性肿瘤，通过手术获得边缘阴性（R₀）切除是eCCA患者最佳治疗选择，然而大多数患者在初诊时已丧失了根治性手术治疗的机会，目前姑息性治疗中放、化疗效果不佳且存在较多不良反应，而胆道支架引流、免疫及靶向治疗虽有一定的疗效但也具有自身的局限性，光动力疗法（PDT）作为一种新兴的微创、具有良好耐受性和较小副作用的多学科交叉技术手段，不但可抑制肿瘤生长，还可联合多种治疗方式提高不可切除eCCA患者的生存期和生活质量，因而具有广阔的临床运用前景。本文主要从PDT的机制、光源路径和光敏剂的运用现状及其联合治疗在临床中的应用进行归纳和总结，并且针对目前PDT在治疗eCCA中的临床困境提出了潜在的应对策略，旨在为eCCA患者的临床治疗方案和科研方向提供依据和参考。

Clinical application and research progress of photodynamic therapy in extrahepatic cholangiocarcinoma

Extrahepatic cholangiocarcinoma (eCCA) is a highly aggressive malignant tumor originating from the epithelial cells of the extrahepatic bile duct. Surgical resection with negative margins (R₀) is the most optimal treatment for eCCA patients. However, most patients have already lost the opportunity for radical surgical treatment at the time of initial diagnosis. Currently, palliative therapies such as radiation and chemotherapy yield poor results and come with significant adverse reactions. While biliary stenting, immunotherapy, and targeted therapy have particular efficacy, they also have limitations. Photodynamic therapy, as an emerging minimally invasive interdisciplinary technique with good tolerability and minimal side effects, not only inhibits tumor growth but also, in combination with various treatment modalities, enhances the survival and quality of life for unresectable eCCA patients. Therefore, it holds promising clinical prospects. This article mainly summarizes the mechanisms of photodynamic therapy, the current application status of light sources and photosensitizers, and combined treatments in clinical practice. Additionally, potential strategies to address the current clinical challenges of photodynamic therapy in treating eCCA are proposed to provide a basis and reference for clinical treatment options for eCCA patients and its research directions.